| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTER FOR BENEFITS MANAGEMENT, INC3 | 24651 CENTER RIDGE ROAD, SUITE 110 WESTLAKE, OH 44145 | UNITED HEALTHCARE INSURANCE COMPANY | — | $33K | $33K | 2.19% |
| THE CHELKO CONSULTING GROUP3 Filed as: THE CHELKO CONSULTING GROUP, LLC | 24651 CENTER RIDGE ROAD, SUITE 110 WESTLAKE, OH 44145 | UNITED HEALTHCARE INSURANCE COMPANY | — | $12K | $12K | 0.78% |
| THE CHELKO CONSULTING GROUP3 Filed as: THE CHELKO CONSULTING GROUP, LLC | 24651 CENTER RIDGE ROAD, SUITE 110 WESTLAKE, OH 44145 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $86 | $3K | 2.74% |
| WELLS FARGO INSURANCE SERVICES3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.02% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.02% |
| CENTER FOR BENEFITS MANAGEMENT, INC3 | 24651 CENTER RIDGE ROAD, SUITE 110 WESTLAKE, OH 44145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 14.18% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 178 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 263 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 271 | $121K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $77K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $77K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $77K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 263 | $1.5M |
| Other(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 263 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 271 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.